Program Announcement and Proposed Special Consideration for Grants for Residency Training and Advanced Education in the General Practice of Dentistry for Fiscal Year 1995

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

RIN 0905-ZA81

Program Announcement and Proposed Special Consideration for

Grants for Residency Training and Advanced Education in the General

Practice of Dentistry for Fiscal Year 1995

The Health Resources and Services Administration (HRSA) announces

that applications will be accepted for fiscal year (FY) 1995 Grants for

Residency Training and Advanced Education in the General Practice of

Dentistry under the authority of section 749, title VII of the Public

Health Service Act (the Act), as amended by the Health Professions

Education Extension Amendments of 1992, Pub. L. 102-408, dated October

13, 1992. Comments are invited on the proposed special consideration.

Approximately $3,600,000 will be available in FY 1995 for this

program. Total continuation support recommended is approximately

$1,600,000. It is anticipated that $2,000,000 will be available to

support 16 to 18 competing awards averaging $125,000.

Previous Funding Experience

Previous funding experience information is provided to assist

potential applicants to make better informed decisions regarding

submission of an application for this program. There was no competitive

cycle for FY 1994. In FY 1993, HRSA reviewed 45 applications for Grants

for Residency Training and Advanced Education in the General Practice

of Dentistry. Of those applications, 64 percent were approved and 36

percent were disapproved. Seventeen projects, or 38 percent of the

applications received, were funded.

Purpose

Section 749 of the PHS Act authorizes the Secretary to make grants

to any public or nonprofit private school of dentistry or accredited

postgraduate dental training institution (e.g., hospitals and medical

centers) to plan, develop, and operate an approved residency or an

approved advanced educational program in the general practice of

dentistry; to provide financial assistance to participants in such a

program who are in need of financial assistance and who plan to

specialize in the practice of general dentistry; and to fund

innovative, nontraditional models for the provision of postdoctoral

General Dentistry training.

Eligible Applicants

To be eligible for a Grant for Residency Training and Advanced

Education in the General Practice of Dentistry, the applicant shall:

(a) be a public or nonprofit private school of dentistry or an

accredited postgraduate dental training institution (hospital, medical

center, or other entity) and be accredited by the appropriate

accrediting body, and

(b) be located in any one of the several States of the United

States, the District of Columbia, the Commonwealth of Puerto Rico, the

Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam,

American Samoa, the Trust Territory of the Pacific Islands (the

Republic of Palau), the Republic of the Marshall Islands, and the

Federated States of Micronesia.

To receive support, programs must meet the requirements of final

regulations at 42 CFR Part 57, subpart L. The period of Federal support

should not exceed 3 years.

Categories of Program Support

There will be no funding preference between residency training

programs and advanced educational programs in general dentistry. Grant

support will be available for three distinct categories of program

development. Applications must address at least one of these

categories.

Category 1: Program Initiation

An applicant may request support to assist in establishing a new

program. Support may be for 3 years of program operation, or for up to

1 year of program planning and development, followed by 2 years of

program operation. An applicant must show, at a minimum, preliminary

provisional approval from the Commission on Dental Accreditation before

the initial grant award date (grants will be effective July 1, 1995).

Before a second year grant award will be made, the grantee must show an

accreditation classification of accreditation eligible.

Category 2: Program Expansion

An applicant may request support for an existing program which has

full approval accreditation classification to fund the cost of a first-

year enrollment increase in the program.

Category 3: Program Improvement

An applicant may request support for an existing program which has

conditional approval or provisional approval accreditation to correct

deficiencies or weaknesses in order to gain full approval accreditation

status. Support is also available for an existing program which has

full approval accreditation for changes or additions in faculty,

curriculum and/or facilities to enhance the quality of the program.

National Health Objectives for the Year 2000

The Public Health Service (PHS) is committed to achieving the

health promotion and disease prevention objectives of Healthy People

2000, a PHS-led national activity for setting priority areas. The grant

program for Residency Training and Advanced Education in the General

Practice of Dentistry is related to the priority area of Oral Health.

Potential applicants may obtain a copy of Healthy People 2000 (Full

Report; Stock No. 017-001-00474-0) or Healthy People 2000 (Summary

Report; Stock No. 017-001-00473-1) through the Superintendent of

Documents, Government Printing Office, Washington, D.C. 20402-9325

(Telephone 202-783-3238).

Education and Service Linkage

As part of its long-range planning, HRSA will be targeting its

efforts to strengthening linkages between U.S. Public Health Service

supported education programs and service programs which provide

comprehensive primary care services to the underserved.

Smoke-Free Workplace

The Public Health Service strongly encourages all grant recipients

to provide a smoke-free workplace and promote the non-use of all

tobacco products. This is consistent with the PHS mission to protect

and advance the physical and mental health of the American people.

Review Criteria

The review of applications will take into consideration the

following criteria:

(1) The potential effectiveness of the proposed project in carrying

out the training purposes of section 749 of the Act.

(2) The degree to which the proposed project adequately provides

for meeting the project requirements.

(3) The administrative and managerial capability of the applicant

to carry out the proposed project in a cost-effective manner.

(4) The extent to which the objectives of the program are

consistent with the purposes of the grant program and the extent to

which the evaluation methodology will effectively assess the impact of

the project.

(5) The extent to which the proposal demonstrates a need for the

project.

(6) The extent to which present or potential problems are

understood by the applicant and the extent to which solutions to these

problems have been developed.

(7) The extent to which the organizational and administrative

relationships between institutional and programmatic components of the

project enhance the achievement of project objectives.

(8) The extent to which the curriculum will enhance the trainee's

ability to become an efficient, effective, and competent practitioner

of general dentistry.

(9) The qualifications of proposed staff and faculty.

(10) The extent to which the trainee recruitment and selection

process assures that highly qualified trainees with a true interest in

general practice are enrolled in the program.

(11) The extent to which the facilities and equipment used in the

training program are appropriate to the general practice of dentistry.

(12) The potential of the project to continue on a self-sustaining

basis after the period of grant support.

(13) The extent to which the budget justification is reasonable and

indicates that institutional support to the project is provided to the

maximum extent possible.

(14) The degree to which the proposed project proposes to attract,

maintain and graduate minority and disadvantaged students.

Other Considerations

In addition, the following funding factors may be applied in

determining funding of approved applications.

A funding preference is defined as the funding of a specific

category or group of approved applications ahead of other categories or

groups of approved applications.

A funding priority is defined as the favorable adjustment of

aggregate review scores of individual approved applications when

applications meet specified criteria.

Special consideration is defined as the enhancement of priority

scores by merit reviewers based on the extent to which applications

address special areas of concern.

It is not required that applicants request consideration for a

funding factor. Applications which do not request consideration for

funding factors will be reviewed and given full consideration for

funding.

Statutory General Preference

As provided in section 791(a) of the PHS Act, preference will be

given to any qualified applicant that--

(A) has a high rate for placing graduates in practice settings

having the principal focus of serving residents of medically

underserved communities; or

(B) during the 2-year period preceding the fiscal year for which

such an award is sought, has achieved a significant increase in the

rate of placing graduates in such settings.

This preference will only be applied to applications that rank above

the 20th percentile of proposals recommended for approval by the peer

review group.

``High rate'' is defined as a minimum of 25 percent of graduates in

academic year 1991-92, 1992-93 and 1993-94, who spend at least 50

percent of their worktime in clinical practice in the specified

settings. Graduates who are providing care in a medically underserved

community as a part of a fellowship or other educational experience can

be counted.

``Significant increase in the rate'' means that, between academic

years 1992-93 and 1993-94, the rate of placing graduates in the

specified settings has increased by a minimum of 50 percent and that

not less than 15 percent of graduates from the most recent year are

working in these settings.

Additional information concerning the implementation of this

preference has been published in the Federal Register at 59 FR 15741,

dated April 4, 1994.

Established Funding Preference

The following funding preference was established in FY 1992 after

public comment (57 FR 11325, dated April 2, 1992) and the

Administration is extending this preference in FY 1995. In determining

the order of funding of approved applications, a funding preference

will be given to approved applications which propose to establish new

Post Graduate Year-1 training positions, whether through the

establishment of a new program or the expansion of an existing program.

First funding within this preference will be for approved

applications designed to offer substantial clinical experiences for

trainees to provide primary care services to underserved and high risk

populations. The experiences must include training at one or more of

the following entities: PHS 332 health professional shortage area

(HPSA); health care facility that draws at least 50 percent of its

patients from HPSA designated areas or populations; PHS 329 migrant

health center; PHS 330 community health center; health care facility of

the Indian Health Service (IHS); State designated clinic/center serving

an underserved population, or other rural/urban health clinic that

meets grant program requirements.

Applicants may address the funding preference by:

1. Establishing a new accredited advanced general dentistry program

in one or more of the prescribed entities;

2. Establishing trainee off-site rotations into one or more of the

prescribed entities as part of a new or existing advanced general

dentistry program; or

3. Increasing the number of training positions in an existing

advanced general dentistry program that currently provides training

experiences in one or more of the prescribed entities, either by

location of the primary site or by off-site rotations.

The following guidelines must be addressed within the application

when requesting the funding preference:

(a) The new training positions must be PGY-1 positions.

(b) In regard to service to underserved and high risk populations,

20 percent of each resident's training time over the course of the

training program must occur in one or more of the above eligible

settings.

Established Funding Priority

In determining the order of funding of approved applications, a

funding priority will be given to applicants which demonstrate either

substantial progress over the last three years or a significant

experience of ten or more years in enrolling and graduating trainees

from those minority or low-income populations identified as at risk of

poor health outcomes.

Proposed Special Consideration

It is proposed that special consideration will be given to approved

applications based on the extent to which they address innovative means

of providing advanced general dentistry education that can help meet

the current and future demand of such training. This might include new

sponsor/co-sponsor arrangements; different organizational and

administrative structures; expanded private/public sector affiliations

and setting linkages; and creative applications for current

instructional telecommunications and computer technologies.

Information Requirements Provision

Under section 791(b) of the Act, the Secretary may make an award

under the Grants for Residency Training and Advanced Education in the

General Practice of Dentistry program only if the applicant for the

award submits to the Secretary the following information:

1. A description of rotations of preceptorships for students, or

clinical training programs for residents, that have the principal focus

of providing health care to medically underserved communities.

2. The number of faculty on admissions committees who have a

clinical practice in community-based ambulatory settings in medically

underserved communities.

3. With respect to individuals who are from disadvantaged

backgrounds or from medically underserved communities, the number of

such individuals who are recruited for academic programs of the

applicant, the number of such individuals who are admitted to such

programs, and the number of such individuals who graduate from such

programs.

4. If applicable, the number of recent graduates who have chosen

careers in primary health care.

5. The number of recent graduates whose practices are serving

medically underserved communities.

6. A description of whether and to what extent the applicant is

able to operate without Federal assistance under this title.

Additional details concerning the implementation of this information

requirement have been published in the Federal Register at 58 FR 43642,

dated August 17, 1993, and will be provided in the application

materials.

Paperwork Reduction Act

The standard application form PHS 6025-1, HRSA Competing Training

Grant Application, General Instructions and supplement for this program

have been approved by the Office of Management and Budget under the

Paperwork Reduction Act. This approval includes the burden for

collection of information for the statutory general preference and for

the information requirement provision. (OMB #0915-0060, expiration date

7/31/95)

Definitions

The following definitions apply to those training sites/facilities

included in the proposed funding preference listed above:

``Community health center'' means an entity as defined in section

330 of the Public Health Service Act and in regulations at 42 CFR

51c.102(c).

``Health professional shortage area'' means an area designated

under section 332 of the PHS Act.

``Migrant health center'' means an entity as defined in section

329(a) of the Public Health Service Act and in regulations at 42 CFR

56.102(g)(1).

Additional Information

Interested persons are invited to comment on the proposed special

consideration. The comment period is 30 days. All comments received on

or before December 1, 1994 will be considered before the final special

consideration is established. Written comments should be addressed to:

Mr. Neil Sampson, Director, Division of Associated, Dental, and Public

Health Professions, Bureau of Health Professions, Health Resources and

Services Administration, Parklawn Building, Room 8-101, 5600 Fishers

Lane, Rockville, Maryland 20857.

All comments received will be available for public inspection and

copying at the Division of Associated, Dental, and Public Health

Professions, Bureau of Health Professions, at the above address,

weekdays (Federal holidays excepted) between the hours of 8:30 am and

5:00 pm.

Application Requests

Grant application materials are being mailed only in response to

requests received. Requests for application materials and questions

regarding grants policy and business management issues should be

directed to: Ms. Judy Bowen, Grants Management Specialist (D-30),

Bureau of Health Professions, Health Resources and Services

Administration, 5600 Fishers Lane, Room 8C-26, Rockville, Maryland

20857, Telephone: (301) 443-6960.

Completed applications should be sent to the Grants Management

Branch at the above address.

If additional programmatic information is needed, please contact:

Dr. Rosemary Duffy, Division of Associated, Dental, and Public Health

Professions, Bureau of Health Professions, Health Resources and

Services Administration, 5600 Fishers Lane, Room 8C-15, Rockville,

Maryland 20857, Telephone: (301) 443-6837.

The deadline date for receipt of applications is January 25, 1995.

Applications will be considered to be ``on time'' if they are either:

(1) Received on or before the established deadline date, or

(2) Sent on or before the established deadline date and received in

time for orderly processing. (Applicants should request a legibly dated

U.S. Postal Service postmark or obtain a legibly dated receipt from a

commercial carrier or U.S. Postal Service. Private metered postmarks

shall not be acceptable as proof of timely mailing.)

Late applications not accepted for processing will be returned to

the applicant.

Grants for Residency Training and Advanced Education in the General

Practice of Dentistry is listed at 93.897 in the Catalog of Federal

Domestic Assistance. Applications submitted in response to this

announcement are not subject to the provisions of Executive Order

12372, Intergovernmental Review of Federal Programs (as implemented

through 45 CFR part 100). This program is not subject to the Public

Health System Reporting Requirements.

Dated: September 28, 1994.

Ciro V. Sumaya, M.D., M.P.H.T.M.

Administrator.

[FR Doc. 94-26996 Filed 10-31-94; 8:45 am]

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